Lower urinary tract symptoms (LUTS) suggestive of benign prostatic obstruction (BPO) are common in the aging male There are few well-designed, long term, multi-center, randomized clinical trials comparing the subjective and objective outcomes of physiotherapy of prostatic symptoms (POPS) AIM 1 To collaborate with a research consortium to design and conduct a multi-center randomized phase III clinical trial comparing saw palmetto, Pygeum africanum, or a placebo for treatment of symptomatic BPH AIM 2 To recruit and randomize 300 men (in two years) with symptomatic BPH who meet the protocol guidelines AIM 3 To design and implement a prospective randomized controlled trial for treatment of BPH that will determine which of the following predict successful treatment outcomes patient characteristics, AUA symptoms score, uroflow rate, and prostate size AIM 4 To design and implement recruitment interventions among racial and ethnic minority men and procedures for the maintenance of the long-term participation of study subjects.